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Cited by 158Abdominal vascular conditions and treatmentsAortic Thrombus and EmbolismAcute Ischemic Stroke Management

Acute thrombo-embolic occlusion of the superior mesenteric artery: a prospective study in a well defined population

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Acosta, S., Björck, M.·2003·European Journal of Vascular and Endovascular Surgery
DOI 10.1053/ejvs.2002.1893
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Abstract

Objectives to characterize the clinical presentation of patients with acute thrombo-embolic occlusion of the superior mesenteric artery (SMA). Design prospective study. Materials twenty-four consecutive patients admitted to Blekinge County Hospital, Karlskrona, Sweden, with acute thrombo-embolic occlusion of the SMA, over a three-year period from April 1999 through March 2002. Methods clinical data were registered prospectively. Incidence, diagnostic procedures and factors associated with survival were analysed. Results the diagnosis was verified at operation in 20, and at autopsy in 4 patients. The incidence was 5.3 per 100 000 inhabitants per year. Among the 20 patients with embolic disease, atrial fibrillation was present in 95%, synchronous embolic events in 30% and warfarin treatment in 10%. D-dimer was elevated on admission in 13/13. Four patients were diagnosed at first consultation. Fifteen underwent curative revascularisation (6) or bowel resection only (9). Five were alive at one-year follow-up, of whom one had short bowel syndrome. Length of bowel ischaemia predicted institutional (p = 0.004) and one-year mortality (p = 0.005). Conclusions the incidence was higher than expected. Embolic occlusions predominated. Old age, atrial fibrillation, severe abdominal pain and synchronous embolus suggest the diagnosis of acute bowel ischaemia. Length of bowel ischaemia predicted outcome.

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  • Clinical signs of acute mesenteric ischaemia are non-specific and reliable specific biomarkers are lacking, so diagnosis is often delayed.

    “As clinical signs of AMI are non-specific and reliable specific biomarkers are lacking, the diagnosis is often delayed resulting in progression of intestinal ischaemia to transmural intestinal necrosis and peritonitis before the diagnosis is made.”

    From Incidence and outcomes of acute mesenteric ischaemia: a systematic review and meta-analysis (2022) · cites this paper as [121]

  • The overall incidence of AMI is low, 0.09-0.2% of all acute admissions to emergency departments.

    “The overall incidence is low (0.09–0.2% of all acute admissions to emergency departments), representing an infrequent cause of abdominal pain [4–6], but a common cause of emergent intestinal resection.”

    From Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. (2022) · cites this paper as [4]

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Authors
Acosta, S., & Björck, M.
Affiliations
  • Blekingesjukhuset (SE)
  • Uppsala University Hospital (SE)
Corresponding author
Acosta, S.
ORCID
Venue
European Journal of Vascular and Endovascular Surgery
Publisher
Elsevier BV
Published
2003-08
Volume
26
Issue
2
Pages
179-183
ISSN
1078-5884 (ISSN-L)
DOI
10.1053/ejvs.2002.1893
OpenAlex
W2016158593
Cited by
158
References
11
Citations by year
2026: 6 · 2025: 9 · 2024: 11 · 2023: 13 · 2022: 9 · 2021: 12 · 2020: 13 · 2019: 4 · 2018: 4 · 2017: 6 · 2016: 7 · 2015: 6 · 2014: 4 · 2013: 8 · 2012: 8
FWCI
3.20
Type
journal article
Language
en
Open access
Licence
Locations
  • European Journal of Vascular and Endovascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Thrombus and Embolism
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
Keywords
superior mesenteric artery occlusion, acute thromboembolism, acute mesenteric ischemia, embolic occlusion, atrial fibrillation, warfarin, D-dimer, bowel resection, short bowel syndrome, mortality, incidence
MeSH terms
Acute Disease, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Sweden, Thromboembolism, Mesenteric Artery, Superior

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